Provider Demographics
NPI:1609066976
Name:SEGURA, JOSEPH TERRY (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:TERRY
Last Name:SEGURA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4475 WESTBANK EXPY
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-3102
Mailing Address - Country:US
Mailing Address - Phone:504-347-8471
Mailing Address - Fax:504-340-2885
Practice Address - Street 1:4475 WESTBANK EXPY
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-3102
Practice Address - Country:US
Practice Address - Phone:504-347-8471
Practice Address - Fax:504-340-2885
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA011658207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAB89686OtherUPIN